Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: McClure RJ[original query] |
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A systemic approach to achieving population-level impact in injury and violence prevention
Smith LS , Wilkins NJ , McClure RJ . Syst Res Behav Sci 2020 The contemporary public health model for injury and violence prevention is a four-step process, which has been difficult to fully actualize in real-world contexts. This difficulty results from challenges in bridging science to practice and developing and applying population-level approaches. Prevention programmes and policies are embedded within and impacted by a range of system-level factors, which must be considered and actively managed when addressing complex public health challenges involving multiple sectors and stakeholders. To address these concerns, a systemic approach to population-level injury and violence prevention is being developed and explored by the Division of Analysis, Research, and Practice Integration in the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. This article makes the case for and provides a high-level overview of this systemic approach, its various components, and how it is being applied in one governmental unit. Published 2020. This article is a U.S. Government work and is in the public domain in the USA |
Injury prevention: achieving population-level change
Wilkins N , McClure RJ , Mack K . Inj Prev 2018 24 i1-i2 Injury remains a leading cause of death and disability for all sectors of the community in all regions of the world.1–3 Since the 1960s when injury was conceptualised as a public health problem, there has been an escalation of knowledge relating to ‘what works’ to prevent injury. However, the rapid development of new injury prevention knowledge is quickly outstripping society’s capacity to implement it.4 This supplement of Injury Prevention brings together examples of empirical-based injury prevention research that demonstrate the state-of-the-art methods of achieving population-level reductions in injury-related harm. The issue also includes contributions that make the case for expanding existing public health paradigms of injury prevention beyond ‘what works’ and towards understanding the contexts and supports necessary for embedding effective injury prevention interventions within sustainable, synergistic systems of safety promotion. |
Physician dispensing of oxycodone and other commonly used opioids, 2000-2015, United States
Mack KA , Jones CM , McClure RJ . Pain Med 2017 19 (5) 990-996 Objective.: An average of 91 people in the United States die every day from an opioid-related overdose (including prescription opioids and heroin). The direct dispensing of opioids from health care practitioner offices has been linked to opioid-related harms. The objective of this study is to describe the changing nature of the volume of this type of prescribing at the state level. Methods.: This descriptive study examines the distribution of opioids by practitioners using 1999-2015 Automation of Reports and Consolidated Orders System data. Analyses were restricted to opioids distributed to practitioners. Amount distributed (morphine milligram equivalents [MMEs]) and number of practitioners are presented. Results.: Patterns of distribution to practitioners and the number of practitioners varied markedly by state and changed dramatically over time. Comparing 1999 with 2015, the MME distributed to dispensing practitioners decreased in 16 states and increased in 35. Most notable was the change in Florida, which saw a peak of 8.94 MMEs per 100,000 persons in 2010 (the highest distribution in all states in all years) and a low of 0.08 in 2013. Discussion.: This study presents the first state estimates of office-based dispensing of opioids. Increases in direct dispensing in recent years may indicate a need to monitor this practice and consider whether changes are needed. Using controlled substances data to identify high prescribers and dispensers of opioids, as well as examining overall state trends, is a foundational activity to informing the response to potentially high-risk clinical practices. |
A review of CDC's Web-based Injury Statistics Query and Reporting System (WISQARS: Planning for the future of injury surveillance
Ballesteros MF , Webb K , McClure RJ . J Safety Res 2017 61 211-215 Introduction: The Centers for Disease Control and Prevention (CDC) developed the Web-based Injury Statistics Query and Reporting System (WISQARSTM) to meet the data needs of injury practitioners. In 2015, CDC completed a Portfolio Review of this system to inform its future development. Methods: Evaluation questions addressed utilization, technology and innovation, data sources, and tools and training. Data were collected through environmental scans, a review of peer-reviewed and grey literature, a web search, and stakeholder interviews. Results: Review findings led to specific recommendations for each evaluation question. Response: CDC reviewed each recommendation and initiated several enhancements that will improve the ability of injury prevention practitioners to leverage these data, better make sense of query results, and incorporate findings and key messages into prevention practices. |
Injury surveillance as a distributed system of systems
McClure RJ , Mack K . Inj Prev 2015 22 Suppl 1 i1-2 The contemporary definition of surveillance is | The ongoing systematic collection, analysis, and interpretation of health data essential to the planning, implementation and evaluation of public health practice, closely integrated with timely dissemination of these data to those who need to know. The final link the surveillance chain is the application of these data to prevention and control.1 | In 2008, Professor Pless wrote an excellent criticism of modern injury surveillance in a commentary in this Journal; Surveillance alone is not the answer.2 The main point of the commentary was in his observation that, | I question whether there is any evidence that a surveillance system—even one that operates perfectly—actually contributes to prevention. …. Surveillance is sterile and pointless if it is not somehow tied to preventive interventions. | There are three ways for injury surveillance to fail the ‘Pless test’. The first way to fail is by not getting the right information into the right hands in a time and matter that allows data to be used for prevention programmes. The second way to fail is to spend ones resources looking for data, when data is not what is needed to solve the problem. Not recognising this distinction in circumstances where the second case holds true, can create accelerated efforts to collect “more and better” data in a vain attempt to improve injury outcomes, when the resources should be better applied elsewhere. The third way to fail the test as originally stated is an inevitable consequence of the wording of the challenge. An injury surveillance system could clear the first two hurdles yet still fail if data translation and implementation are outcomes for which the surveillance system is being held accountable. |
Injury prevention as social change
McClure RJ , Mack K , Wilkins N , Davey TM . Inj Prev 2015 22 (3) 226-9 We will not solve the public health problem of injury simply by educating individuals about the nature of injury risk, improving their risk assessment and providing these individuals with information to enable them to reduce the level of risk to which they are exposed. Substantial improvement in the societal injury burden will occur only when changes are made at the societal level that focus on reducing the population-level indicators of injury.1,2 The shift from an individual to a population perspective has substantial implications for the way we perceive, direct, undertake, and evaluate injury prevention research and practice. The analogy of ‘the population as patient’ provides a clear illustration of the foundational truths that underpin the preferred public health approach to the prevention of injury. | Society is the system within which populations exist. Sustained change made at the societal level to reduce population-level indicators of injury morbidity and mortality involves systemic change. In this paper, we consider a shift from the contemporary systematic approach to unintentional injury and violence prevention,3 to a systemic approach4 more consistent with the principles of ecological public health.5 We consider the extent to which the logic of the systematic model, and the related misconceptions about the role of uncertainty in science, limit local, national and global efforts to minimise injury-related harm. We explore the implications of a systemic perspective for the field of injury prevention and conclude by delineating a new programme of work that could be of considerable benefit to the injury-related health of populations. |
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